Open mitral valve replacement with a balloon-expandable prosthesis using the valve-in-valve technique: a case report

Mitral defects are the most common acquired heart disturbances. The only radical treatment for severe valve stenosis or its insufficiency is surgical correction of the defects. The main challenge of implanting a mechanical mitral prosthesis is associated to its thrombosis complication that demands repeated surgical intervention on re-replacement of the mitral prosthesis. Herein, a clinical case of patient P. (58 years old) is presented, who was admitted to the Federal Center for Cardiovascular Surgery (Penza, Russia) with thrombosis of the mitral valve prosthesis and its dysfunction. The patient has already been undergone repeated surgery to replace the mitral valve. The purpose of the clinical case description is to demonstrate the using of open mitral valve replacement method based on the valve-in-valve technique with a transcatheter balloon-expandable prosthesis, its efficacy and safety. The considered method of treatment can simplify the main stage of the surgical intervention; reduce the time of artificial circulation and aortic clamping as well as the number of intraoperative complications. This type of surgical treatment can be considered as an option for re-prosthesis in patients at high surgical risk who are indicated for re-intervention due to impaired function of previously implanted heart valve prosthesis. A clinical case attests the possibility, efficacy and safety of using a balloon-expandable prosthesis for mitral valve replacement with the valve-in-valve technique upon repeated surgical interventions.